Many treatable causes of erythropoietin resistance (also known as erythropoietin hypo-responsiveness) exist in patients with chronic kidney disease (CKD) stages 3 to 5 . Well recognized causes of erythropoietin resistance include iron deficiency, severe hyperparathyroidism, chronic infection, vitamin deficiency, aluminum toxicity and poor dialysis adequacy. Furthermore, many diseases resulting in the chronic inflammatory state have also been associated with erythropoietin resistance in Non-CKD patients with diseases such as chronic congestive heart failure, chronic liver disease and many connective tissue diseases including rheumatoid arthritis and systemic lupus.